HIV/AIDS

Since 1984, RTI has been at the forefront in both international and domestic HIV-related research and interventions. Our work encompasses both HIV prevention and care for those in low-resource settings and for people considered most at risk for HIV, including vulnerable women, injecting drug users, and men who have sex with men.

We also provide comprehensive technical assistance to U.S. federal agencies, international health ministries and local governments, donors, foundations, and other clients seeking to prevent the spread of HIV in the United States and around the world.

Our HIV portfolio is grounded in rigorous scientific investigation and evidence-based practice. In 2011-2012, more than 110 peer-reviewed, HIV-related manuscripts were published in scientific journals globally. In July 2012, we had a significant presence at AIDS 2012, the 19th International AIDS Conference in Washington, DC.

Current Programs and Accomplishments

Core Activities in Multiple Countries

The core of our HIV-related work is in nearly two dozen countries. Our programs range from developing locally appropriate risk reduction interventions in Botswana and the Republic of Georgia, to training health care workers in performing safe male circumcision in Uganda, to providing technical assistance to and capacity building of local organizations in China, Indonesia, and Vietnam so they may effectively work with governments and other key partners in scaling up evidence-based prevention interventions and improving HIV policies and processes.

A Focus on Women's Health

We are working to increase HIV prevention and contraceptive health choices among women around the world. Programs led by Dr. Ariane van der Straten have shown that using a vaginal ring to deliver a microbicide for HIV prevention is a viable and acceptable HIV prevention method for women in Sub-Saharan Africa who had never been exposed to them before. We are currently working on a large multisite qualitative study, embedded in the phase III ASPIRE trial, that assesses the effectiveness of a microbicide ring to prevent HIV acquisition in women in Southern Africa. The qualitative study will provide crucial data on acceptability and adherence to this novel microbicide delivery mechanism. In addition, we are starting a study among American couples to assess the feasibility of another women-controlled prevention method – silicone-based female condoms – in the United States.

Health Communications Expertise

We are applying our health communications expertise to help the Centers for Disease Control and Prevention develop and evaluate its Act Against AIDS national communication campaign (www.actagainstaids.org). We provide formative research to identify target audiences, test campaign messages and concepts with these groups, and evaluate campaign activities. Our health communications experts, with funding from the Agency for Healthcare Research and Quality, have also successfully piloted a novel intervention using text messages to improve medication adherence, reduce sexual risk behaviors, and enhance social support among HIV-positive patients. We are now extending this expertise to help the Health Resources and Services Administration develop, implement, and evaluate UCARE4LIFE. UCARE4LIFE will be a text messaging-based intervention for racial and ethnically diverse HIV-positive youth in the South to improve retention in care and HIV medication adherence.

Community-Based Interventions

One of CDC's "best evidence" interventions to reduce HIV risk, Dr. Wendee Wechsberg's Women's CoOp program, has continued to be adapted to new settings and populations in 2012. Initially designed for African-American crack-using women, we adapted this program for use with African-American teenage girls and for women and couples in South Africa. The intervention is also being integrated with a drug abuse treatment approach to test with female IDUs in the Republic of Georgia, and is being incorporated into combination HIV prevention activities (i.e., seek, test, treat, and retain) in Pretoria, South Africa. The Women’s CoOp has also been packaged and is ready to be scaled up across South Africa.

Safer Syringes

Our work around the use of low dead space syringes, led by Dr. William Zule and Harry Cross, is gaining global momentum to end use of specific types of syringes that waste medication and may be fueling HIV epidemics among people who inject drugs in countries throughout the world. The threat lies in the design of syringes, which results in wasted medication and increased risk of disease transmission if the syringes are shared. Continued research and advocacy have led to new recommendations from the World Health Organization and the Global Fund to Fight AIDS, Tuberculosis, and Malaria to distribute only the safer type syringes through their programs.

Surveillance and Epidemiology

We work with foreign ministries, militaries, national AIDS committees, HIV care and treatment centers, and other stakeholders worldwide to establish wide-reaching HIV surveillance systems and electronic databases to collect information on clinical and behavioral aspects of HIV, estimate prevalence rates, and answer complex research questions not easily answered through small cohorts. We conduct rigorous epidemiological research and provide technical assistance in developing surveillance activities and data management systems in challenging resource-poor settings to enhance global knowledge of the HIV/AIDS epidemic.